Managing COPD: October 14, 2013

COPD is a progressive lung disease; described as a mixture of asthma, emphysema and chronic bronchitis; marked by constant coughing, people with advanced disease struggle to breath. It’s a top cause of hospital stays.

“It is a very high cause of hospital admissions. The chances of developing respiratory failure - which is the inability to breathe, the inability to get enough oxygen, are very high,” says Dr. Sagar Naik, pulmonologist with Lee Memorial Health System.

Brought on by inflammation from inhaling irritants like cigarette smoke, the lungs become tight. Nationally between 20 and 24% of hospitalized COPD patients will be back within 30 days.

“Once they’re in the hospital, they’re away from the smoke, they’re getting all their medicines, and they feel better. They go home. Unfortunately, they re-enter the same environment again where cigarette smoke is prevalent, they start smoking, they may not have access to the medicines and the same symptoms quickly return,” says Dr. Naik.

To stop the cycle experts looked outside the hospital and into the home. Transitioning patients into a COPD management program based on each person’s need.

“We discovered some patients have oxygen tubing that would be 50-75 foot which means the patient isn’t getting any of the oxygen. They had large machines rather than portable concentrators they could carry. They weren’t taking their medication correctly,” says Joan Carroll, director of the care transitions program with Lee Memorial Health System.

Over a period of weeks discharged patients are taught to use their equipment, monitor medication and conserve energy, and given detailed instructions.

Taking the time to teach helped drop the readmission rate down to 7-8%.

“What caused us to take the initiative for this program was to identify what are the barriers that patients with COPD have that are causing them to be readmitted and what can we do to help them get over these barriers,” says Dr. Naik.

“It’s doing the right thing for people and I think that’s what we’re about,” says Carroll.